Objective
Hepatitis B virus (HBV) infection remains a serious public health problem, due in part to low vaccination rates among high-risk adults, many of whom decline vaccination because of barriers such as perceived inconvenience or discomfort. This study evaluates the efficacy of a self-prediction intervention to increase HBV vaccination rates among high-risk adults.
Method
Randomized controlled trial of 1175 adults recruited from three STD clinics in the United States over 28 months. Participants completed an audio-computer-assisted self-interview (A-CASI), which presented information about HBV infection and vaccination, and measured relevant beliefs, behaviors and demographics. Half of participants were assigned randomly to a "self-prediction" intervention, asking them to predict their future acceptance of HBV vaccination. The main outcome measure was subsequent vaccination behavior. Other measures included perceived barriers to HBV vaccination, measured prior to the intervention.
Results
There was a significant interaction between the intervention and vaccination barriers, indicating the effect of the intervention differed depending on perceived vaccination barriers. Among high-barriers patients, the intervention significantly increased vaccination acceptance. Among low-barrier patients, the intervention did not influence vaccination acceptance.
Conclusions
The self-prediction intervention significantly increased vaccination acceptance among "high-barriers" patients, who typically have very low vaccination rates. This brief intervention could be a useful tool in increasing vaccine uptake among high-barriers patients.
Objectives
To determine the contraceptive needs (including emergency contraception (EC)) of women seeking care from a publicly-funded sexually transmitted infection (STI) clinic and to better understand women’s knowledge of and attitudes towards EC.
Methods
An anonymous survey was administered to 197 women seeking services at one Chicago Department of Public Health STI clinic.
Results
After excluding women unlikely to become pregnant within the next year because of age, sexual orientation, hysterectomy, and those that desired pregnancy (n=47), data from 150 women were available for analysis. Thirteen percent were using “very effective” contraception (intrauterine contraception, implant, or sterilization) and 26% were using “effective” contraception (contraceptive pill, patch, ring or injectable). Approximately 23% (95% CI 16.5–30.0%) may have benefited from immediate use of EC as they reported at least one act of unprotected intercourse within the past 5 days.
Conclusion
Many women seeking care from public STI clinics are at high risk of unintended pregnancy. A substantial number of women have an immediate need of EC at the time of their clinical visit. Efforts are needed to improve provision of EC as well as effective ongoing contraception for this population.
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